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Isoniazid Prophylaxis

John B. Bass Jr, MD; Dixie E. Snider Jr, MD, MPH
JAMA. 1987;258(7):911. doi:10.1001/jama.1987.03400070048025.
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To the Editor.—  We wish to call attention to an error in a recent US PREVENTIVE SERVICES TASK FORCE report.1 The American Thoracic Society and the Centers for Disease Control recommend isoniazid prophylaxis for all infected persons (ie, those with positive tuberculin skin test reactions) less than 35 years of age, not just those with special risk factors as stated in the Task Force report.Infected persons 35 years old or older should receive prophylaxis if they have additional risk factors, such as recent exposure to an individual with tuberculosis, a documented recent skin test conversion (especially if the increase in reaction size is 12 mm or more), a fibrotic lesion on a chest roentgenogram with negative cultures, or one of a variety of medical risk factors such as human immunodeficiency virus infection, silicosis, or gastrectomy.2Isoniazid prophylaxis is highly effective in preventing disease and is safe when


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